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The Pop Reporter®

Volume 3, Number 30
28 July 2003

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"The Pop Reporter" (R) Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs INFO Project When you click on any link below, your Internet browser will access a Web site not connected to "The Pop Reporter." Information accessed through these links and contained in this issue of "The Pop Reporter" does not necessarily state or reflect the views of the INFO Project, Johns Hopkins University, or the US Agency for International Development. All links were verified at the date of mailing. Your computer and/or network configuration regarding Java script, cookies, and other security issues may not allow you to view certain Web sites. Consult your computer technician if you are having problems.

Family Planning/Reproductive Health Research

Human Papillomavirus: Epidemiology and Public Health (review article)
This article summarizes some evolving concepts regarding HPV molecular epidemiology and prevention of cervical cancer.

Clinical Breakage, Slippage and Acceptability of a New Commercial Polyurethane Condom: A Randomized, Controlled Study (research abstract)
This paper reports on a study carried out in the Paris region of France on a new, commercial polyurethane condom marketed in Japan as Sagami Original and in Europe as Protex Original. A standard latex condom complying with the European standard for condoms from the same manufacturer was used as the control in the study. The clinical breakage rate for the polyurethane condom was 0.6% compared to 1.3% for the latex condom. The difference was not statistically significant. Clinically significant slippage (complete slippage of the condom off the penis) was 1.1% for the polyurethane condom, compared to 0.5% for the latex; a difference that again was not statistically significant. The polyurethane condom was therefore equivalent to the latex condom in terms of clinical failure rate.

Factors Associated with Maintenance of Regular Condom Use among Single Heterosexual Adults: A Longitudinal Study (research abstract)
This study describes behavioural and psychosocial characteristics of single heterosexuals towards regular condom use and identifies factors associated with the maintenance of this behavior over time. A cohort of 179 single heterosexual adults (83 men and 96 women, mean age: 32 years) was followed over a period of 2 years, with data collected by phone interviews at baseline and 1 and 2 years. Over time, no significant change was observed regarding condom use. The psychosocial variables remained stable. To have a favourable intention was the main factor associated with maintenance of condom use. Having had a STD, personal normative beliefs, and positive attitude were also associated with regular condom use.

Cervical Schistosomiasis, Human Papilloma Virus (HPV), and Human Immunodeficiency Virus (HIV): A Dangerous Coexistence or Coincidence? (research abstract)
Through the case history of a woman in Zambia, this article discusses recent data suggesting that the presence of HPV, HIV infection, and cervical schistosomiasis increases susceptibility for other STDs including HIV and HPV. The authors recommend that in patients with schistosomiasis, immediate treatment for schistosomiasis and additional testing for HIV and HPV is warranted.

Genital Ulcers in Women (research abstract)
Women who are of low socioeconomic status are most vulnerable to genital ulcer disease (GUD), particularly those in some African countries where prevalence of chancroid remains high. This report discusses the development of herpes and chancroid vaccines, condom use, and the provision of education and accessible treatment facilities should help those women who now suffer from recurrent GUD infections.

Intrauterine Devices and Pelvic Inflammatory Disease (research abstract)
Much of the resurgence in popularity of the intrauterine device (IUD) is attributable to reassessments of the association between IUD use and pelvic inflammatory disease (PID). In this article, the author examines recent studies that assess the risk of PID with IUD use, explains why some of the assumptions on which the arguments regarding a lack of an association between IUD use and PID are based might not be correct, and recommends additional trials to evaluate IUDs as one of several contraceptive options.

Assessing the Wraparound Process During Family Planning Meetings (PubMed abstract)
This study assessed the fidelity of the wraparound process in a community-based system of care using the Wraparound Observation Form (Second Version). The authors discuss strengths and weaknesses with the current system.

Family Planning/Reproductive Health News

New R30m Condom Factory for South Africa (news article)
A Malaysian business consortium has invested 30 million rand in a condom-making factory in Mpumalanga province that is now ready to go, according to the South African government news agency.

Zimbabwe: Minister of Health Applauds Faith-Based Organizations (news article)
The Minister of Health and Child Welfare applauded faith-based organizations for joining other sectors in the fight against HIV/AIDS. A survey carried out by the Ministry of Health and Child Welfare, UNICEF and UNAIDS recently showed that 1.8 million people were living with HIV/AIDS in the country.

Uganda: Masaka Short of Condoms (news article)
Masaka district, Uganda, has been hit by a shortage of condoms due to increased protective sex awareness, according to a district health educator.

Survey on Ghana's Current Health and Population Status Takes Off (news article)
The article reports that the Ghana Demographic and Health Survey (GDHS) 2003 was launched with a call on policymakers to address chronic child malnutrition and survival needs. The GDHS provides data on fertility; child mortality; life expectancy; maternal care; access to safe drinking water among other demographic and health data on the Ghanaian population.

Family Planning/Reproductive Health Policy

Birth-Rate Policies Whip-Saw Women in Peru (commentary)
The commentator writes that, after forced sterilizations under the former president, Peruvian women now face coercive programs to increase the birth rate. Such extremes are dangerous for women, who deserve control over their health and reproductive destiny.

Lack of Consensus Characterizes Philippine Population Policy (policy brief)
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Related news article: The Philippines: Government Urged to Set Consistent Policy on Population Control
Given the controversial nature of the issue of population growth, there is a need for the government to state clearly its position with respect to family planning alternatives and its role in fertility decision-making of couples. Alejandro Herrin, professor at the UP School of Economics, states in this policy brief that the lack of stable consensus on Philippine government’s policy on population control during the past three decades has been the reason behind the country’s high population growth.

Uganda: MPs to Fight Sebei Female Circumcision (news article)
A bill will be introduced into Parliament to incriminate persons abetting the practice of female genital cutting, according to a member of Parliament.

Pakistan: Vajpayee Calls for More Political Courage against AIDS Epidemic (news article)
Prime Minister Atal Behari Vajpayee pledged an "undelayed response" to India’s AIDS epidemic and admitted New Delhi had been slow in taking action to curb the HIV virus which infects at least 4.58 million Indians. Vajpayee inaugurated a first-of-its-kind AIDS workshop in India of 1,000 policymakers and activists amid warnings by the United Nations that the country of a billion-plus people must act immediately to avoid an AIDS catastrophe.

HIV/AIDS Research

HIV/AIDS and STI Prevention and Care in Rwandan Refugee Camps in the United Republic of Tanzania (report)
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Related news article: Rwanda-Tanzania: Case for Early HIV/AIDS Intervention in Refugee Camps
The report, released jointly by the UNAIDS and the Office of the UN High Commissioner for Refugees, recommends that reproductive and sexual health services, including HIV/AIDS and sexually transmitted infections prevention and care, should be initiated in the early stages of a refugee crisis. The report is based on an intervention program carried out between 1994 and 1996 in Rwandan refugee camps in northwestern Tanzania.

Needle Sharing Among Southern Thai Drug Injectors (research abstract)
This research examines factors associated with needle sharing among injecting drug users (IDU) in southern Thailand. Using a cross-sectional survey, 272 active IDUs were interviewed about their socio-economic background, needle sharing, and drug use patterns at six drug-treatment clinics in southern Thailand. The research suggests that AIDS prevention efforts should focus on approaches to reduce needle sharing and that needle exchange programs, HIV counseling, and testing and bleach distribution may reduce levels of needle-sharing risks.

Knowledge and Perceptions of HIV among Peripartum Women and among Men Whose Wives are of Reproductive Age, Northern Thailand (research abstract)
Researchers conducted 14 focus group discussions and 80 interviews with men and women in Chiang Rai province in northern Thailand to investigate knowledge and perceptions of HIV transmission risk and interest in vaginal microbicides. Participants evinced substantial knowledge about HIV, with two exceptions important for prevention campaigns: (a) confusion about the window period between a new infection and positive HIV-test result and (b) overestimation of the safety of extramarital sex with partners who are not sex workers.

HIV/AIDS News

India Sees Big HIV/AIDS Rise (news article)
Related news article: India: Upward Trend in Official AIDS Estimates
The article reports that more than 4.5 million Indians were infected with HIV by the end of 2002. This number represents a marked increase from the 2001 estimate, which was well below four million. In addition, HIV infection among pregnant women has crossed the 1% mark for the first time.

Pakistan: New Cases of HIV Among Drug Users (news article)
The article reports that in Pakistan's southern Sindh Province, new HIV positive cases have been identified among intravenous drug users. The first were detected in June after a prisoner in the local jail of Larkana, 300 km from the port city of Karachi, tested positive. Health workers said that HIV-positive patients were living in isolation and shunned by the prison authorities in Larkana due to misconceptions over how the disease is transmitted.

South Africa: The Devil Is in the Detail, Projected Benefits of Anti-retroviral Treatment (news article)
The South African government disclosed last week that it can afford an AIDS drug treatment program to prolong the lives of an estimated 1.7 million people living with HIV/AIDS. The report, which was leaked to the press, says the benefit of anti-retroviral treatment is that it reduces AIDS mortality significantly. The Department of Health agreed with the report's finding that 1.7 million fewer people will die between now and 2010 if 100% of people with HIV/AIDS are treated with anti-retroviral drugs.

American Officials Launch Bush's AIDS Initiative In Haiti (news article)
Haiti has become the first country in the world to implement a program spearheaded by US President George W. Bush to stem mother-to-child HIV/AIDS transmission.

India: Prime Minister Says Put Health on Political Agenda (news article)
Related news article: Indian Politicans Urge Greater Action on AIDS Treatment, Prevention
The Indian Prime Minister has made a public statement that health care should be on country's political agenda. The article describes the prime minister’s effort to slow the rapid spread of HIV/AIDS and sexually transmitted diseases.

Maternal and Child Health Research

Cultural Childbirth Practices and Beliefs in Zambia (research abstract)
The aim of this study was to explore cultural childbirth practices and beliefs in Zambia as related by women accompanying laboring women to maternity units. Thirty-six women accompanying laboring women to urban and rural maternity units in Zambia were interviewed. Eighteen of the women considered themselves to be mbusas, or traditional birth assistants, and the rest said that they followed labouring women to maternity units. Researchers found that these social support women, including those who considered themselves as mbusas, lacked understanding of the causes of obstetric complications during childbirth and had inadequate knowledge of the appropriate management of labor.

Health Insurance and Child Mortality in Costa Rica (research abstract)
Researchers used county-level vital statistics and census data to isolate the causal insurance effect on mortality using county fixed effects models. They found that insurance increases were strongly related to mortality decreases at the county level before controlling for other time-varying factors. However, after controlling for changes in other correlated maternal, household, and community characteristics, fixed effects models indicated that the insurance expansion could have explained only a small portion of the mortality change. Their results question the proposition that health insurance can lead to large improvements in infant and child mortality and that expanding insurance to the poor can substantially narrow socioeconomic differentials in mortality.

Seasonality in Urinary and Household Salt Iodine Content among Pregnant and Lactating Women of the Plains of Nepal (research abstract)
In the rural southern plains of Nepal, iodine deficiency remains a mild-to-moderate public health problem among pregnant and lactating women, despite the availability of iodized salt. Researchers studied pregnant and lactating women in three rural communities in the plains of southeastern Nepal. They determined that marked seasonality in salt iodine content may account for the lack of intraindividual correlation between maternal iodine status during pregnancy and postpartum periods and contribute to periodicity in the risk of iodine deficiency.

Did Maternal Mortality Ratio Increase in Malawi between 1992-1998? Review of Malawi Demographic and Health Surveys and Other Data Sources (PubMed abstract)
Despite various programs aimed at reducing the maternal mortality ratio (MMR) and improving reproductive health globally, and in Malawi especially, the 2000 Malawi Demographic and Health Survey (DHS) reported an MMR for Malawi as 1,221 deaths per 100,000 live births. This represented an almost 80% rise from the 620 maternal deaths/100,000 live births estimated in the 1992 DHS. The possible reasons behind the rise in the MMR include: the growing HIV/AIDS pandemic in Malawi with an estimated infection rate of 14%; and the deteriorating healthcare situation and inherent inaccuracies in the estimation of maternal mortality. Continued surveillance and identification of factors responsible for the deterioration of Malawi's MMR are suggested.

Obstructed Labour: A Public Health Problem in Gombe, Gombe State, Nigeria (research abstract)
This study reviewed the cases of obstructed labor seen at the specialist Gombe Hospital (SHG), Gombe State, over 5 years. The incidence of obstructed labor was 4%. The leading cause of obstructed labor was cephalopelvic disproportion (83.0%), and Caesarean section (72.2%) was the most common method of delivery. The authors offer suggestions on how to curb this public health problem.

Risk Factors for Preterm Delivery in South Western Nigeria (research abstract)
This was a case-control study to determine the risk factors of preterm delivery among Nigerian women seen at Obafemi Awolowo University teaching hospital, Ile-Ife, Nigeria over a period of 9 months. Multiple logistic regression revealed 10 potential risk factors: previous preterm delivery, previous second trimester spontaneous abortion, heavy and stressful occupation, premature rupture of fetal membrane, maternal medical disorders, body mass index at delivery of less than 23, antepartum haemorrhage, maternal febrile illness, intrauterine growth retardation, and multiple pregnancy.

Social Monitor: Infant Mortality (report)
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Related press release: UNICEF Report Finds "Child Survival Crisis" in Caucasus and Central Asia
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Infant mortality rates in nine countries of Eastern Europe and the Commonwealth of Independent States are much higher than official figures have long claimed, according to a new report by UNICEF. UNICEF found that in some countries deaths among children less than one year old were four times higher than the official counts.

Which Health Services Reduce Maternal Mortality? Evidence from Ratings of Maternal Health Services (research abstract)
The authors report cross-national regressions for maternal mortality in 49 developing countries, using indices of the adequacy of maternal health services derived from ratings by at least 10 experts per country. As in previous such regressions, a socioeconomic factor - in this case per capita income - has a significant effect, but having a trained attendant at delivery does not. Instead, the ratings index for access to services has a consistent, significant effect regardless of which estimates of maternal mortality ratios are predicted. Further analysis suggests that access to treatment for pregnancy complications and to services that help avoid pregnancy and birth are most closely related to lower mortality. Service ratings are interdependent, however, so that focusing only on individual services may not be productive.

Maternal and Child Health News

Bangladesh: 20,000 Women Die During Childbirth Yearly: SBAs Need to be Created (news article)
Gynaecologists attending a workshop on safe motherhood and emergency obstetric care said that many cases of maternal mortality during childbirth could be avoided by developing Skilled Birth Attendants(SBAs) who can provide effective birth assistance and emergency obstetric care. They announced that the Bangladesh government has taken a national strategy to reduce maternal mortality by creating SBAs for home delivery. One of the major goals of the strategy is for 50% of all childbirths to be assisted by SBAs by 2010.

Maternal Care in India Reveals Gaps Between Urban and Rural, Rich and Poor (feature article)
A national survey in India shows that women who do not seek prenatal care are older (35 to 49), with a high number of previous pregnancies, and are illiterate and socioeconomically disadvantaged. One of every 55 Indian women faces the risk of maternal death, compared with one in 80 in Pakistan and one in 610 in Sri Lanka.

Conflict Imperils Liberia's Reproductive and Child Health Programs (news article)
High rates of childhood illnesses and deaths in Liberia offer some of the clearest signs yet of the impact of Liberia's prolonged war and political instability.

Central Asia-Kazakhstan: Reassessing Infant Mortality Figures (news article)
While Kazakh official statistics continue to record a drop in infant and child mortality figures, such figures may not be an accurate portrayal of the real situation.

US Delivery Debate: Vaginal or C-section? (feature article)
More women are choosing to have Caesarean sections instead of vaginal births, according to a new report, and their decisions, together with doctors' cooperation, has become a contentious subject among obstetricians, politicians and feminists.

Men's Health News

Fetal Exposure to Two Chemicals Cause of Male Reproductive Disorders Later in Life (news article)
Over the last 10 years, US researchers have observed a marked increase in some male reproductive disorders, including undescended testicles, increased instances of testicular cancer, and decreased sperm count. In the last 20 years the rates for testicular cancer have grown almost five-fold in Denmark, yet neighboring Finland has not experienced such a dramatic increase. In an effort to explain this phenomenon, scientists have hypothesized that these human male reproductive deficits may have a common origin: a disturbance in the level of androgen and other critical hormones during fetal development. The results from tests with laboratory animals may help scientists better understand the effect of fetal exposure to certain chemicals has on male reproduction abilities later in life.

India: You've Got No Male (news article)
Men trail far behind their braver halves when it comes to sterilization procedures, so officials in Uttar Pradesh are resorting to creative tactics and incentives to encourage men to opt for no-scalpel vasectomy.

Population Research

2003 World Population Data Sheet (report)
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Related news article: World Population Projections Hint at Risks of Growth
The 2003 World Population Data Sheet documents the dramatic differences in population growth between the have and have-not nations. While some developed countries are experiencing a population nosedive, many poor nations are still adding millions of people to a world of abject poverty, hunger, and disease.

Population News

The Philippines: Fear of Church Prevents Solons from Backing Population Bill (news article)
A senator finds it hard to push for a bill on reproductive health care that may help curb the country’s population growth because his colleagues are afraid to lose the support of the Catholic Church in the coming national elections.

South Africa Population to Drop by 26% (news article)
The population of HIV/AIDS-ravaged southern Africa is expected to decline by 22% by 2050, according to a recent study by Population Reference Bureau. The report estimates that South Africa's population will drop from 44 million this year to 35.1 million in 2025, and to 32.5 million in 2050 - a 26% decline.

Women's Health News

Uganda: Country's Conflict Worsens Reproductive Health Rights (news article)
A reproductive health report on Uganda links continued armed conflict in northern districts of Uganda with increase in women's reproductive health problems.

India: It May Be Their Source of Livelihood, Yet They Say 'No' to Unprotected Sex (feature article)
'Nothing sells like sex,' and who better to say it than commercial sex workers. For many of these streetwalkers here, it is their livelihood. And so they ensure that customers, particularly regulars, get their money's worth. But they still know when to say no. And that is often - when customers demand unprotected sex.

Youth Health News

Botswana: 87% of Young Mothers Not Married (news article)
Study results presented at a local workshop indicate that 87% of young new mothers in Botswana are not married. In addition, 12.3% of women aged 15-24 years have reported that their first sexual intercourse was coerced.

Botswana: Youth and Adolescent Reproductive Health Services Vital (news article)
In the article, the Botswana government reports it has developed a number of policy instruments that guarantee the right of individuals, including young persons, access to sexual and reproductive health services.

Special Reports/Profiles/Resources

Summer 2003 Edition of PATH's Reproductive Health Outlook Website (resource material)
The Reproductive Health Outlook (RHO) website is designed for reproductive health program managers and decision-makers working in developing countries and low-resource settings. RHO provides up-to-date summaries of research findings, program experience, and clinical guidelines related to key reproductive health topics.

New Series of Educational Materials Focused on Adolescent Reproductive Health in Francophone Africa (resource material)
The German Foundation for World Population, Family Care International/Burkina Faso and FCI/Niger announce a series of educational materials focused on adolescent reproductive health in Francophone Africa. The materials include a video and discussion guide titled «Scènes d’adolescence: à vous de jouer» (Scenes of Adolescence: It’s Up To You), which is a series of six video modules, each lasting 12-17 minutes; a handbook «Vous, votre vie, vos rêves: Bien réussir votre adolescence» (You, Your Life, Your Dreams: Making A Success of Your Adolescence) is comprised of fourteen chapters providing exhaustive information on a range of questions of concern to adolescents; and a flipchart for rural girls. This tool addresses the situation, needs, and socioeconomic and health concerns of young rural girls between the ages of 10 and 22.

Community-Based Population and Environment Programs: Integrating Resource Conservation and Reproductive Health (resource material)
This factsheet from Population Action International addresses the linkages between services that combine aspects of natural resources conservation or similar environmental work and the provision of reproductive health services, including family planning.

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